STUDIES ON DIURETICS. II. THE RELATIONSHIP BETWEEN GLOMERULAR FILTRATION RATE, PROXIMAL TUBULAR ABSORPTION OF SODIUM AND DIURETIC EFFICACY OF MERCURIALS 1

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Abstract
A moderate reduction in glomerular filtration rate in the dog greatly reduces the capacity of the kidney to eliminate water and electrolyte. Reduction of filtration rate was accomplished by partially clamping the aorta above the renal arteries. The evidence is interpreted as indicating that this reduction in excretory capacity is largely due to relative overabsorption of salt and water in the proximal segment in consequence of prolonged contact of the filtrate with the tubular epithelium. If filtration rate is significantly below normal, absorption in the proximal segment may be so nearly complete and such small quantities of Na may reach the distal segment, that even were complete blockage of absorption by a mercurial diuretic to result, an insignificant increase in Na excretion would occur. The relation of these findings to the patho-genesis of edema and to the problem of clinical mercurial resistance is discussed.